Kidney pathologies are accompanied by a mass of unpleasant symptoms and significantly complicate the patient's quality of life. And if the pathology is also chronic, the patient is forced to follow certain recommendations all his life to avoid exacerbation of the disease. One such disease is chronic glomerulonephritis.
Glomerulonephritis of a chronic form is called the immunoinflammatory diffuse progressive pathology of the glomerular kidney structures, which inevitably leads to sclerotic damage and kidney failure. According to ICD-10, chronic glomerulonephritis has code N03.
Such pathologies account for about 1-2% of cases. Pathology can be found in any person, regardless of age characteristics and gender. Although most often the first manifestations of pathology appear in the period of 20-40 years. On the development of chronic pathological process says the long-flowing and progressive development of glomerulonephritis, accompanied by bilateral diffuse renal diseas
e. Kidney in chronic glomerulonephritis
It is not always possible to determine the true causes of chronic glomerulonephritis. Most often, the etiology of this pathology is associated with acute inflammatory lesions of allergic or infectious-immunological origin.
- The most common cause of chronic glomerulonephritis is ineffective treatment of acute form of glomerulonephritis.
- The next most common cause is the presence in the body of a constantly acting provoking factor. Kidney inflammation in this case develops gradually, and because of the long-term pathogenetic influence, the acute phase is absent. In the role of provocators, mainly streptococcal chronic infectious foci( maxillary sinusitis and pharyngitis, tonsillitis and carious teeth, periodontal disease or hepatitis, cholecystitis or adnexitis, cystitis, etc.) act as provocators.
- The next cause of chronic glomerulonephritis is long-term organic sensitization, which is most typical for allergy suffererssevere reactions or patients with chronic intoxications, for example, with alcoholism or the constant intake of drugs that are nephrotoxic in
- Heredity can also act as a glomerulonephritis-provoking factor. If there is an immune defect of hereditary origin, then a protective but inadequate response to penetrated pathogens arises in the body
- In addition, factors such as hemorrhagic vasculitis, lupus erythematosus can trigger the development of glomerulonephritis, endocarditis or rheumatism and other systemic pathologies
Pathogenesis and forms of
Experts suggest this classification of chronic glomerulonephritis:
- Latent - it is characterized by the absence of severe symptoms;
- Hypertensive - there are characteristic increases in pressure;
- Hematuric - accompanied by hematuria with different severity, may cause increased blood pressure or hypertension. This form is most common;
- Nephrotic - when the clinic is dominated by a nephrotic syndrome with swelling, proteinuria, etc.;
- Mixed - may be accompanied by any of the above symptoms.
Most primary forms of chronic glomerulonephritis are of an immunocomplex character and are symptomatically similar to an acute form of pathology.
Forms of chronic glomerulonephritis:
Symptoms and signs of
The characteristics of chronic glomerulonephritis are the same manifestations as in the acute form:
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- Renal dysfunction;
- Isolated urinary syndrome.
In general, chronic glomerulonephritis develops in 2 stages. First comes the stage of compensation, in which a pronounced urinary syndrome can manifest itself. Although there are cases when this stage is asymptomatic. Then comes the stage of decompensation of the kidneys, when the urinary symptoms decrease significantly, high blood pressure, moderate puffiness, polyuria, etc. occurs.
On the video, the symptoms of chronic glomerulonephritis:
The leading importance is given to laboratory indicators when diagnosing chronic forms of glomerulonephritis. A typical change in urine is a change in the specific mass of urine, the presence of protein and leukocytes, as well as erythrocytes. To assess renal activity, the patient is assigned Reberg samples and urine analysis according to Zimnitskiy.
Renal ultrasound is also performed, which shows a decrease in kidney due to sclerotic organ changes. Pyelography and urography, nephroscintigraphy, etc. are performed to assess the parenchymal state and determine the degree of renal failure. In addition, an ECG, echocardiogram, an eye examination, ultrasound pleura diagnostics, etc.
is also required. In addition, a differential diagnosis with such pathologies as nephrotic syndrome, pyelonephritis,renal polycystic or tuberculosis, renal stone pathology, hypertension or amyloidosis. For the final diagnosis, a renal biopsy is performed with further morphological examination of the biopsy specimen.
The purpose of treatment is control over the course of pathology, prevention of renal dysfunction, persistent clinical remission. But there are no safe and completely healing methods.
- Cytotoxic drugs block inflammatory autoimmune processes, which helps prevent further renal damage;
- Diuretics eliminate swelling;
- Glucocorticosteroids also stop the inflammatory process, but with severe sclerotic processes in the kidneys, these drugs are contraindicated;
- Antiaggregants, anticoagulants relieve excessive blood flow, restoring normal renal circulation, thereby preventing complications of thromboembolic character;
- Antihypertensive drugs are aimed at reducing high blood pressure.
If adequate therapy is not available, then remission will be impossible. If there is a pronounced deficiency of the kidneys, then hemodialysis is applied. Patients have to resort to artificial kidney several times a month. Unfortunately, all the existing methods of treating chronic glomerulonephritis are palliative, that is, temporarily relieve symptoms.
The most radical method of treatment is a kidney transplant from a donor. Such operations are already quite common and widely practiced in appropriate medical institutions, but there is always a risk of graft rejection or recurrent renal failure.
Therapy for chronic glomerulonephritis requires compliance with a particular clinical regimen and nutritional limitations. Depending on the degree of severity of the pathology, the elimination of psychophysical loads and hypothermia is shown. It is necessary to observe the regime of the day and the diet. It is also necessary to comply with the drinking regime, limiting the consumption of salt.
Treatment of chronic glomerulonephritis:
Effective preventive methods for chronic glomerulonephritis have not been developed for today. Some clinical cases, including aggravation, are quite possible to prevent by timely therapy of infectious or autoimmune pathologies, as well as through the prevention of diabetes, etc.
Predictions for chronic forms of glomerulonephritis depend on the specific situation and type of pathology.
Complications and consequences of
One of the dangerous consequences of chronic glomerulonephritis is amyloidosis. This is a dangerous pathology, which is accompanied by the deposition in the body of a pathological protein substance - amyloid, which disrupts the functionality of the body. In the case of glomerulonephritis, the deposition is noted in the kidney structures, which leads to chronic lumbar vertebral pain and hyperthermia.
In addition, among the common complications of pathogens, there are also thromboses, cerebral circulation disorders, left ventricular failure, renal eclampsia, etc. Prophylactic medical examinations will allow timely detection of pathology and start its timely treatment, which minimizes the risk of complications.